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NPI Code Detail

MEDICARE: MS. RACHAEL R MCCLELLAN RDN

MEDICARE: MS. RACHAEL R MCCLELLAN RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education Nutritionist86028218MI
2174H00000XHealth Educator86028218MI
3133V00000XRegistered Dietitian86028218MI

General Provider Information

NPI Number : 1750794012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHAEL R MCCLELLAN RDN
Provider Business Mailing Address
First Line : 1203 JAMES WALTER DR
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-7232
Country : US
Telephone Number : 224-829-7522
Fax Number :
Provider Business Practice Location Address
First Line : 1350 SCENIC HWY N STE 266
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-7924
Country : US
Telephone Number : 224-829-7522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 08/25/2025

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